Superbugs: Evolution, Resistance Mechanisms & Impact on Health

World health leaders have described superbugs as “nightmare bacteria” that “pose a catastrophic threat” to people in every country in the world. Understanding how superbugs develop, what their resistance mechanisms are, and the impact they have on human health is key to combatting the threat.

How do Superbugs Evolve?

Superbugs evolve in a few ways. When bacteria grow and spread, they can develop mutations in their DNA that make them resistant to certain types of drugs. When antibiotics are used to treat an infection, bacteria without the resistance mechanism die, while those that have the resistance mechanism may continue to live and multiply. Bacteria can also give certain resistance mechanisms to other bacteria in a process called horizontal gene transfer, which increases the speed at which bacteria can evolve into superbugs.

Watch Bacteria Evolve into Superbugs

To learn more about individual superbug species, download the bad bugs flash cards.

Antibiotic Resistance Mechanisms in Superbugs

Superbugs’ resistance mechanisms take a variety of forms. Some act like camouflage, hiding the bacterium’s vulnerable cell wall from the antibiotic, while others act like shields against antibiotics. One of the most pernicious resistance mechanisms is a biological pump that actively flushes an antibiotic compound out of the bacterium. Some bacteria have enzymes that can degrade antibiotics before they do any damage. As these resistance mechanisms continue to change and spread among superbugs, antibiotics can become ineffective, and the threat of antibiotic resistance becomes more urgent than ever. The impact on human health is clear:

At least 2,000,000 people acquire drug-resistant infections in the United States each year, and at least 23,000 people die

C. difficile infections incur more than $1,000,000,000 in excess medical costs every year

Up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed

More than 800,000 gonorrhea infections occur each year, 246,000 of which are drug-resistant, according to CDC estimates

Up to half of all blood infections caused by CRE (Carbapenem-resistant Enterobacteriaceae) result in death

Treating & Preventing Superbug Infections

When first-line and then second-line antibiotic treatment options are limited by resistance or are unavailable, healthcare providers are forced to use antibiotics that may be more toxic to the patient and frequently more expensive. Even when alternative treatments exist, research has shown that patients with resistant infections are often much more likely to die, and survivors have significantly longer hospital stays, delayed recuperation, and long-term disability.

Efforts to prevent such threats build on the foundation of proven public health strategies: immunization, infection control, protecting the food supply, antibiotic stewardship, and reducing person-to-person spread through screening, treatment and education.

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